Ageism, Race and Ethnicity

Older people of color, ethnic minorities and migrants are largely ignored

The Administration for Community Living (“ACL”), an operating division of the US Department of Health and Human Service that includes the US Administration on Aging, reported that the US population age 65 and over increased from 37.8 million in 2007 to 50.9 million in 2017 (a 34% increase) and was projected to reach 80.8 million by 2040 (over twice their number in 2000) and 94.7 million in 2060.[1]  People age 65 and over represented 15.6% of the population in the year 2017 but were expected to grow to be 21.6% of the population by 2040.  Notably, racial and ethnic minority populations increased from 7.2 million in 2007 (19% of the older adult population) to 11.8 million in 2017 (23% of all older adults) and were projected to increase to 27.7 million in 2040 (34% of all older adults).  According to the report, while the white (not Hispanic) population age 65 and over was projected to increase by 36% between 2017 and 2040, the increase among older racial and ethnic minority populations during that period was expected to be 135%, including Hispanics (188%), African-Americans (not Hispanic) (96%), American Indian and Alaska Native (not Hispanic) (85%), and Asians (not Hispanic) (123%).[2]

As noted above, 23% of the persons who were age 65 and over in 2017 were members of racial or ethnic minority populations—9% were African-Americans (not Hispanic), 4% were Asian (not Hispanic), 0.5% were American Indian and Alaska Native (not Hispanic), 0.1% were Native Hawaiian/Pacific Islander, (not Hispanic) and 0.8% of persons age 65 and over identified themselves as being of two or more races.  Persons of Hispanic origin (who may be of any race) represented 8% of the older population. Only 9% of all the people who were members of racial and ethnic minority populations were age 65 and over in 2017 compared to 20% of non-Hispanic whites. The percentages of people age 65 and over within each racial and ethnic minority group were as follows: 11% of African-Americans (not Hispanic), 12% of Asians (not Hispanic), 9% of Native Hawaiian and Other Pacific Islanders (not Hispanic), 11% of American Indian and Alaska Native (not Hispanic), and 7% of Hispanics.[3]

The UN Independent Expert on the Enjoyment of All Human Rights by Older Persons has noted that “[a]ge and race combined create aggravating forms of discrimination and can cause an increased risk of dehumanization of older persons with minority ethnic background”.[4]  She reported that “racial and ethnic minority groups are more likely to enter old age in poorer health and at greater risk of vulnerability owing to chronic inequalities and widespread racial discrimination and exclusion” and that “[o]lder members of ethnic minorities are more likely to live in poorer quality, unsafe and overcrowded accommodation in severely deprived areas that have poor access to facilities, thereby maximizing loneliness and social exclusion”.[5]  The Independent Expert argued that systematic disparities at the intersection of ageism and racism are rarely addressed in policy and practice and that racism exists in care settings and older members of ethnic minorities experience worse conditions in employment, such as lower wages, longer hours, unsafe environments and higher risk of unemployment, all of which create additional risks for health and poverty in old age.[6]

Describing the impact of the intersection of age, race and ethnicity begins with understanding the lives and experiences of people of color before they reach older age.[7]  Chonody and Teater observed that the “lived experience for people of color in the United States is different than the one experienced by Caucasians”, but noted that there is also a great deal of diversity within and between racial and ethnic groups.[8]  For example, in 2018 they reported that the life expectancies among African Americans of both genders continued to lag far behind Caucasians; however, Hispanic Americans of both genders were outliving white Americans.  The ACL report referred to above included comparisons among racial and ethnic groups on various measures of economic wellbeing, such as the fact that while households containing families headed by persons age 65 and over reported a median income in 2017 of $61,946 there was substantial variation among groups: $66,142 for non-Hispanic whites, $40,512 for Hispanics, $43,705 for African-Americans, and $67,627 for Asians.[9]  In 2017, 9.2% of all people age 65 and over were below the poverty level; however, while the rate among older whites was below the average (7.0%) the impact of poverty among older African Americans (19.3%), older Asians (10.8%) and older Hispanics (17.0%) was significantly higher.[10]  Education is foundational to economic progress and the percentage of all older persons who had completed high school rose from 28% to 87% between 1970 and 2018; however, while the rate among whites (not Hispanic) exceeded the average (91%), other groups still lagged behind: 77% of Asians (not Hispanic), 78% of African-Americans (not Hispanic), 75% of American Indian and Alaska Natives (not Hispanic), and 57% of Hispanics.[11]

The UN Independent Expert on the Enjoyment of All Human Rights by Older Persons has expressed particular concerns regarding the health of older members of racial and ethnic minority groups.  Noting that they were more likely to enter old age in poorer health, the Independent Expert called out the challenges that older members of racial and ethnic minority groups face due to barriers to accessing certain health-care services owing to an absence of services in their communities, cultural differences influencing their health beliefs and behaviors, language barriers, high insurance costs and unfamiliarity with the system.[12]  The Independent Expert referred to the problems that ethnic minorities encountered during the Covid-19 pandemic including being targeted for physical and online verbal abuse and denied access to health care and information regarding the pandemic, and warned of the continue effects of racism in care settings where there is evidence of deprecatory humor and micro-aggressions and clear racist acts and institutional racism.[13] 

Reporting on the situation in Europe, Ageing Equal observed that “[r]acial and ethnic minority groups are likely to enter old age in poorer health and at greater risk of vulnerability due to life-long differential treatments”.[14]  Ageing Equal noted that older people from ethnic minorities in Europe reported poorer health outcomes than older white people across the entire range of social and economic conditions and that their health problems were compounded by barriers to accessing certain healthcare services “due to cultural differences influencing their health beliefs and behaviors, language barriers, and unfamiliarity with the system”.[15]  For example, studies showed that Black and other minority ethnic people were diagnosed with dementia on average 4.5 years younger than their white counterpart, possibly due to cultural bias in memory testing and diagnosing the condition, and non-Caucasian people had poor access to health services due to the location of the neighborhoods where they lived and the meager resources available to them there.  Ageing Equal also pointed out that among ethnic communities in which the practice and tradition is that family members take care of the old and frail, the quality of care was compromised due to the lack of social and financial support.

Ageing Equal also noted that older people of color, ethnic minorities and migrants in Europe generally faced a number of challenges with respect to employment including not only the typical problems that older people have in finding a job but also the likelihood that the jobs that are available to them will be of low quality (i.e., lower wages, longer hours, unsafe working conditions and higher risk of unemployment) and dangerous to their physical and mental health.[16]  Members of this group have low levels of education, which impair their ability to be included in society and improve their technical skills as they grow older.  Ageing Equal argued that racial discrimination and exclusion is widespread in Europe and isolation for members of this group is compounded by their low economic status, which means they are often find themselves living in poor housing.

To learn more, go to www.olderpersonsrights.org and download the Older Persons’ Rights Project’s chapter on Ageism, Race and Ethnicity.  

Sign up for e-mail updates about the Project here.

Notes

[1] 2018 Profile of Older Americans (Washington DC: Administration for Community Living, April 2018), 3 (sources for the data in the report included the US Census Bureau’s Population Estimates; Population Projections; Current Population Survey, Annual Social and Economic Supplement; and American Community Survey. Sources also include the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, and the Administration for Community Living’s State Program Report data).

[2] There is a great deal of variation in the terms used to describe the racial and ethnic groups and the author acknowledges that those inconsistencies are repeated in this work.  As a general rule, the descriptive terms used in the text are the same as those used in the sources cited in the particular discussion (e.g., “African Americans”, “Blacks”, “whites”, “Caucasians”, “Hispanics” etc.).

[3] 2018 Profile of Older Americans (Washington DC: Administration for Community Living, April 2018), 5.

[4] Report of the Independent Expert on the Enjoyment of All Human Rights by Older Persons, A/HRC/48/53 (August 4, 2021), Paragraph 55 (citing S. Thompson, Age Discrimination (Ware: Russell House Publishing, 2005)).

[5] Id. at Paragraphs 56 and 57 (citing M. Evandrou and others, “Ethnic inequalities in limiting health and self-reported health in later life revisited”, Journal of Epidemiology and Community Health, 70 (7) (2016), 653).

[6] Id. at Paragraphs 55 and 57 (citing S. Chaouni, “Elderly care must pay more attention to exclusion mechanisms” (June 11, 2021)).  See also Ageism And Race (Ageing Equal) (“Racial and ethnic minority groups are likely to enter old age in poorer health and at greater risk of vulnerability due to life-long differential treatments … [and] … older people of color, ethnic minorities and migrants is a growing population in Europe that faces specific challenges in accessing employment, housing, health and care services, etc.”).

[7] According to Yolanda Moses, a professor of anthropology who has studied origins of social inequality in complex societies: “’People of color’ is a term primarily used in the United States and Canada to describe any person who is not white. It does not solely refer to African-Americans; rather, it encompasses all non-white groups and emphasizes the common experiences of systemic racism”.  See Y. Moses, “Is the Term “People of Color” Acceptable In This Day and Age?”, Sapiens (December 7, 2016).  While the term dates back to 1796 and has been mainstreamed in discussions of racism, it remains controversial for, among other things, lumping together a number of groups with various different experiences.  Recent responses to this concern have included the acronym “BIPOC “, which stands for black, Indigenous and people of color.  See S. Garcia, “Where Did BIPOC Come From?, The New York Times (June 17, 2020).   

[8] J. Chonody and B. Teater, Social Work Practice with Older Adults: An Actively Aging Framework for Practice (Thousand Oaks CA: Sage Publications Inc., 2018), 45.   

[9] 2018 Profile of Older Americans (Washington DC: Administration for Community Living, April 2018), 9.  Another 4.9% of older adults were classified as "near-poor" (income between the poverty level and 125% of this level).  The report noted that the methodology used for the Supplemental Poverty Measure (“SPM”) released by the US Census Bureau in 2011 actually showed that a significantly higher number of older persons (14.1%) below poverty than was shown by the official poverty measure.  The report explained that, “[u]nlike the official poverty rate, the SPM takes into account regional variations in the cost of housing etc. and, even more significantly, the impact of both non-cash benefits received (e.g., SNAP/food stamps, low income tax credits, and WIC) and non-discretionary expenditures including medical out-of-pocket (MOOP) expenses” and that “[f]or persons 65 and over, MOOP was the major source of the significant differences between these measures”.  Id. at 10-11.

[10] Id. at 10.

[11] Id. at 12.  While certain groups still lagged well behind Whites (not Hispanic), they all experienced significant gains in educational levels from 1970 to 2018 (e.g., in 1970, only 9% of older African-Americans were high school graduates).

[12] Report of the Independent Expert on the Enjoyment of All Human Rights by Older Persons, A/HRC/48/53 (August 4, 2021), Paragraph 56 (citing A. Szczepura, “Access to health care for ethnic minority populations”, Postgraduate Medical Journal, 81(953) (2005), 141 and M. Evandrou and others, “Ethnic inequalities in limiting health and self-reported health in later life revisited”, Journal of Epidemiology and Community Health, 70 (7) (2016), 653).

[13] Id. at Paragraphs 55 and 57 (citing Special Rapporteur on minority issues, “COVID-19 fears should not be exploited to attack and exclude minorities – UN expert” (March 30, 2020) and S. Chaouni, “Elderly care must pay more attention to exclusion mechanisms” (June 11, 2021)).

[14] Ageism And Race (Ageing Equal).

[15] Id.

[16] Id.